Cervical Screening | Colposcopy

Try not to worry if you are referred for a colposcopy. It is very unlikely that you have cancer. Your gynaecologist is just checking whether any cells in your cervix are abnormal and if you need treatment to remove them. If there is a moderate to high risk of the cells becoming cancerous if they are left untreated, there are a number of simple and effective treatments that can be used to remove them making absolutely sure that any abnormal cells are investigated and treated early before they have any opportunity to develop into cancerous cells.

No, any abnormal cells will not get worse while you are waiting for the procedure. And, with our clinic, we can offer you an appointment quickly so you don’t have the stress of waiting.

A colposcopy does not hurt although it can feel a bit uncomfortable, particularly if we need to take a biopsy, which is a small sample of tissue cells. Your gynaecologist will check with you throughout the procedure how you are feeling. If you are experiencing uncomfortable at any point, please say so.

Bleeding

Bleeding in between periods can be worrying, but there are often causes to your symptoms. Sometimes there is nothing to worry about, however it is always best to seek accurate diagnosis so you can put your mind at rest and ensure the causes are treated effectively.

Cervical erosion, also known as cervical ectropion, or cervical ectopy, is reaonsably common among young women, of childbearing age.

The term cervical erosion can be misleading, as your cervix isn’t actually eroding. It occurs when the soft cells inside the cervical canal spread to the outer area of your cervix. Normally, outside your cervix there are hard cells, known as epithelial cells.

This condition is not considered a disease, it isn’t cancerous and it doesn’t affect fertility. However, it can cause issues for some women and diagnosis is always best to ensure the right course of treatment.

 

If you are experiencing bleeding in between what would be your natural period cycle, and you don’t want to treat this with hormones, your doctor may consider a endometrial ablation.

This procedure removes the endometrium, the lining of the uterus.

Typically, in most cases, this stops you having periods, or at the least your periods should be very light or return to normal.

Vaginal Prolapse

In some cases the prolapse may protrude outside your vagina, but not in all. In many cases you may feel a lump inside your vagina. Sometimes a prolapse is asymptomatic (there are no symptoms) in which case treatment is not normally recommended.

A vaginal prolapse may cause discomfort or pain during sexual intercourse. In some cases they may produce a heavy, dragging feeling inside your vagina or just a vague sensation that something is different.

In many cases, yes they can, either through physiotherapy to strengthen your pelvic floor muscles or through surgery. If the prolapse can’t be fixed you may be offered something to help you manage the symptoms, such as a pessary to support the prolapse.

Ovarian Cysts

Ovarian cysts don’t normally prevent women from getting pregnant, although they can sometimes make it harder. If you have to have surgery to remove a cyst, make sure you talk to the surgeon about your plans to have children. The surgeon will aim to preserve your fertility wherever possible but if you have to have both ovaries removed, it will prevent you from producing any more eggs.

No, not necessarily. High levels of the same chemical can also be linked to endometriosis, fibroids, pelvic infection and your menstrual period. Talk to your GP or gynaecologist who will be able to provide more specific information.

It is true. The majority of cysts are non-cancerous both before and after menopause however there is a slightly higher risk of ovarian cancer after the menopause.

Fibroids

There are a number of different types of Fibroid:

  • Intramural Fibroids are the most common type. These develop in the muscle wall of the womb.
  • Subserosal Fibroids develop outside the wall of the womb. They can grow into the pelvis and become very large.
  • Submucosal Fibroids develop in the muscle under the inner lining of the womb and can grow into the cavity of the womb.

You may experience a mild cramping sensation during the procedure. In some cases you will be offered a local or general anaesthetic.

Fibroids are very common – as many as one in three women will get them at one point in their life. They don’t usually cause symptoms and will usually go away by themselves. If you are worried, talk to your GP or gynaecologist who should be able to reassure you and can arrange further diagnostic tests, if necessary.

Minimal Access Surgery

You will be given a local or a general anaesthetic, depending on the reason you have been referred for the hysteroscopy. You will be asked to lie on a couch with your legs in supports. The doctor may use an instrument called a speculum to get a better view of your cervix. If you’ve ever had a smear test you will be familiar with this. The hysteroscope is then gently inserted via your vagina into your womb. Fluid is pumped inside your womb to make it easier for the doctor to see. The camera will relay images onto a monitor so the doctor can identify and treat any abnormalities.

No. You may experience a slight cramping sensation, similar to period pain, but the procedure is not painful.

You will be able to return to your normal day-to-day activities the following day, or even on the same day. You may experience some slight bleeding or spotting for a few days, which is normal and nothing to worry about. You should avoid having sex until the bleeding has stopped to minimise the risk of infection. Your doctor will contact you to talk to you about what was found during the procedure.

Pelvic pain

During pregnancy, you may develop pregnancy-related pelvic girdle pain (PPGP), which is caused by stiffness in your pelvic joints or the joints moving unevenly. If you develop PPGP you may experience:

  • pain at the front of your pelvis, above the pelvic bone
  • pain across one or both sides of your lower back
  • pain in your perineum (the bit between your vagina and your bottom)
    you may also develop pain in your thighs

Treatments for PPGP include:

  • exercises to strengthen your pelvic floor, stomach, back and hip muscles
  • pain relief such as TENS
  • a pelvic support belt or crutches
  • manual therapy

You may also be able to relieve some of the pain by:

  • Resting when you can but making sure you remain active as much as possible without exacerbating the pain.
  • Wearing flat, supportive shoes.
  • Keeping your knees together when you get out of the car – if you sit on a plastic bag it can help you to swivel in your seat.
  • Sleep on your side with a pillow between your knees.
  • Taking things slowly and asking for help from those around you.

It is important to talk to your GP or gynaecologist if you experience pelvic pain during pregnancy as it can also be caused by ectopic pregnancy, which can be serious and requires urgent treatment.

Pelvic pain can vary in intensity and can be constant or intermittent. If you are experiencing pain on a regular basis, even if it is fairly mild, it is a good idea to see your doctor.

Endometriosis occurs when small pieces of the womb lining are found outside the womb, such as on the ovaries, vagina or fallopian tubes. You can read more about the condition here

Vulval Conditions

Vulval cancer is a rare type of cancer that mostly affects women over the age of 65. There are only 1200 cases in the UK each year. Symptoms can include:

  • persistent vulval itch, pain or soreness
  • a lump or wart-like growth on the vulva
  • patches or red skin or sores
  • bleeding from the vulva or blood-stained vaginal discharge
  • a burning pain when you wee
  • a mole on the vulva that has changed shape or colour

These symptoms do not necessarily mean you have cancer but it is important to visit your doctor to be on the safe side. If you do have cancer, the earlier it is detected the better your chances of successful treatment.

The skin of the vulva and surrounding area is very sensitive and easily irritated by chemicals that are found in soap, bubble bath and scented wipes. It is a good idea to avoid using chemically-based products if you can. Washing the vulva with water is perfectly adequate or try using an emulsifying ointment such as Dermol 500. If the skin is sore you can use a bland moisturiser but nothing perfumed. Use soft, white, non-recycled toilet paper and cotton pads or tampons.

Yes, anything that contains harsh chemicals can irritate this delicate skin, or worsen existing problems. Avoid detergents that contain dyes, perfumes or enzymes (referred to as biological washing powder). Choose dermatologically-approved detergents or those recommended for babies. Avoid fabric conditioners. Ensure your underwear is rinsed thoroughly so no traces of detergent remain.

Menopause

Symptoms of menopause can start a few months or even years before your periods stop. This is known as the perimenopause.

Yes, as a woman approaches the menopause her periods can become much lighter or heavier than before. They may also become irregular. You may have a period every two or three weeks and then you may not have one for several months. In time they will stop altogether.

Not all women experience the same symptoms during menopause. Some of the more common symptoms include hot flushes, night sweats, difficulty sleeping, vaginal dryness and loss of libido. But you may only experience a few of these symptoms and they may vary in severity from one woman to the next.

PMS

As many as three out of four women experiences PMS to varying degrees. However, if the symptoms are severe or are impacting your life it doesn’t mean you just have to live with it. There are things you can do to ease your symptoms and there are treatments available if the symptoms are severe.

The exact cause of PMS is not known but changes in hormone levels that occur through a woman’s menstrual cycle are believed to play a part.

There is no definitive test for PMS. Your doctor will discuss your symptoms with you. It is likely that you are suffering from PMS if:

  • you experience symptoms associated with PMS for three consecutive menstrual cycles
  • your symptoms ease when your period starts and disappear altogether within a few days

It is a good idea to keep a note in your diary of when the symptoms occur and when they lessen and go away.

Premature ovarian insufficiency

Doctors can’t say exactly why this happens to some women. In some cases, early menopause can be triggered by certain health conditions or treatments, for example, if you have undergone chemotherapy or radiotherapy, or if you have surgery to remove your ovaries. If your mother or sister had an early menopause there is a higher possibility that you may also do so. Or if you have certain health conditions such as the autoimmune disease Lupus, hypothyroidism or Graves’ disease you may be more likely to have an early menopause.

Unfortunately not. Once menopause has begun there is usually nothing that can be done to reverse it. However, if you want to have children and have not already done so you may be able to conceive using eggs donated by another woman. Your gynaecologist will be able to advise you.

Your doctor or gynaecologist will discuss your symptoms with you and will carry out a blood test. This tests for raised levels of Follicle Stimulating Hormone (FSH), which stimulates your ovaries to produce Oestrogen. When the production of Oestrogen falls, your levels of FSH rise. If FSH rises above a particular level, it indicates that you are menopausal.

Useful Links:

5. Menopause: www.menopausematters.co.uk
6. Premature ovarian insufficiency: www.Daisynetwork.org.uk
7. PMS: www.pms.org.uk
8. The Royal College oF Obstetricians & Gynaecologists have patient information leaflets on a wide range of topics for Obstetrics and gynaecology at https://www.rcog.org.uk/en/patients

Our approach is to provide medical expertise, backed by sensitivity, reassurance and personalised care.

Many gynaecology symptoms and conditions are common. We are with you at every step so you can get back to feeling yourself.